McNeil Dawn Elizabeth, Coté Timothy R, Clegg Limin, Mauer Alvin
Division of Cancer Epidemiology and Genetics, Genetic Epidemiology Branch, National Cancer Institute/NIH, EPS Room 7125, 6120 Executive Boulevard, MSC 7236, Rockville, MD 20892-7236, USA.
Med Pediatr Oncol. 2002 Dec;39(6):554-7; discussion 552-3. doi: 10.1002/mpo.10161.
Acute lymphoblastic leukemia (ALL) represents the most common malignancy of childhood. Its incidence peaks in children just before school entry age; i.e., in 2-3 year olds. It is known to be more common in white children in the USA; the incidence is also higher in boys than girls.
We reviewed the 5,379 cases of ALL among persons under 20 years of age in the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database.
The overall incidence of ALL was 26/10(6) person-years between 1973 and 1998, but increased from 19/10(6) person-years in 1973-77 to 28/10(6) person-years in 1993-98 (P < 0.0001). Rates were 44% higher among Whites compared to Blacks (27/10(6) person-years vs. 15/10(6) person-years, P < 0.0001). In 1992-1998, the incidence rate for Hispanics was 43/10(6) person-years, significantly higher than non-Hispanics (28/10(6), P < 0.0001). White children with ALL had better 5-year survival rates than Black children with ALL (71% vs. 58%, P < 0.0001), and 5-year survival was poorest among black males.
ALL incidence has increased over the examined 25-year period. The rate in US whites is higher than that of US Blacks, and the rates in the Hispanic subgroup are the highest of all. While the median survival period is now more than 10 years overall, the 5-year survival rate remains poor for Black males under 4 years of age. Socioeconomic factors do not account for this difference, which may relate to ALL subtype distribution.
急性淋巴细胞白血病（ALL）是儿童期最常见的恶性肿瘤。其发病率在即将进入学龄期的儿童中达到峰值，即2 - 3岁儿童。在美国，已知白人儿童中更为常见；男孩的发病率也高于女孩。
我们回顾了美国国立癌症研究所监测、流行病学和最终结果（SEER）数据库中20岁以下人群的5379例ALL病例。
1973年至1998年期间，ALL的总体发病率为每10万人年26例，但从1973 - 1977年的每10万人年19例增加到1993 - 1998年的每10万人年28例（P < 0.0001）。白人的发病率比黑人高44%（每10万人年27例对每10万人年15例，P < 0.0001）。1992 - 1998年，西班牙裔的发病率为每10万人年43例，显著高于非西班牙裔（每10万人年28例，P < 0.0001）。患有ALL的白人儿童的5年生存率高于患有ALL的黑人儿童（71%对58%，P < 0.0001），而黑人男性的5年生存率最差。
在研究的25年期间，ALL发病率有所增加。美国白人的发病率高于美国黑人，西班牙裔亚组的发病率在所有群体中最高。虽然总体中位生存期现在超过10年，但4岁以下黑人男性的5年生存率仍然很低。社会经济因素无法解释这种差异，这可能与ALL的亚型分布有关。
